Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OT015771 | PA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS019037 | PA |
NPI | 1114337508 |
---|---|
Provider Name | Jennifer Hwang |
First Address | Newtown Square, PA 19073-2304 |
Second Address | Newtown Square, PA 19073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2014 |
Last Update Date | 09/07/2018 |